Screening

Hi:

Can you please tell me why screening for lung cancer with imaging tools is not currently recommended? What if you have a family history (mother and maternal uncle with lung cancer and father and paternal uncle with colon cancer) and you are a former smoker (15-year smoker; 1 pack per day; quit 5 years ago)? Thank you for your kind response.

It would be best to talk about it with your doctor, as a case to case individual approach is always suitable.
The general recommendation is based on previous experience with screening tests. Even smokers are included in those people who participated, so higher risk groups were represented. The screening test should be able to capture disease at an earlier stage where a curative intervention can be applied. The current information shows that the number of people who develop advanced disease does not decrease with the screening test, and so the numbers who would be expected to die per year are not decreasing despite the application of the screening test.
Hence, there is no clear benefit. There is also an uncertain risk (of how high or how low) regarding the application of radiation yearly as the screening test (currently the CT scan is being touted as the imaging tool for these screening studies) may also promote the development of lung cancer.
Remember this is screening, meaning people who have no symptoms. If you do feel something, then the situation changes. This is also as far as general recommendations go, I think that role of the doctor is to provide information and help the individual patient make a decision. Something similar exists for prostate cancer, the screening doesn’t improve survival, so it is not recommended. But it is offered to men, because it could empower them to make a decision, which is also something very important.

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